NPIMap

Organization Active NPI

San Diego Laboratory LLC

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1649578428
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A84519 Issued in CA
Legal business name
SAN DIEGO LABORATORY LLC
Practice address
1800 S Robertson Blvd
#149
Los Angeles, CA 90035-4359
Phone
(310) 273-8885
NPI assigned
Mar 3, 2011
Last updated
Mar 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ara Salazar
Title
Administrator, B&C
Phone
(310) 273-8885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A84519 CA Primary

Addresses

Primary practice location

1800 S Robertson Blvd
#149
Los Angeles, CA 90035-4359

Mailing address

1800 S Robertson Blvd
#149
Los Angeles, CA 90035-4359
Phone (310) 273-8885

National Provider Directory

National Provider Directory

Locations

1800 S Robertson Blvd
#149
Los Angeles, CA 90035

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1649578428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 S ROBERTSON BLVD",
            "address_2": "#149",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354359",
            "telephone_number": "310-273-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S ROBERTSON BLVD",
            "address_2": "#149",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354359",
            "telephone_number": "310-273-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "ARA",
        "authorized_official_title_or_position": "ADMINISTRATOR, B&C",
        "authorized_official_telephone_number": "310-273-8885"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A84519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.